Individual
MICHAEL D LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
202 DUKE OF GLOUCESTER ST SW, ROANOKE, VA 24014-1372
(540) 345-4900
(540) 345-4179
Mailing address
202 DUKE OF GLOUCESTER ST SW, ROANOKE, VA 24014-1372
(540) 345-4900
(540) 345-4179
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
0102049900
VA
207RG0100X
Gastroenterology Physician
519
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821040155
—
VA
05
—
T00390
—
SC
Enumeration date
05/16/2006
Last updated
03/04/2011
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